Published in 2016, this is a textbook that I have cited and recommended in a number of talks on transoral laser microsurgery (TLM). The content and layout is very similar to that of Steiner and Ambrosch’s Endoscopic Laser Surgery of the Upper Aerodigestive Tract, published in 2000. Indeed, the authors of both textbooks have collaborated in the production of this work, with Steiner and Ambrosch both contributing chapters and previous line drawings. Steiner and Ambrosch’s text was seen as the definitive guide for many years, but this new text should be viewed as complimentary and as an updated version. The only slight concern I have with this text, as a single book for surgeons learning these operations, is that the surgical principles of TLM resection techniques (multiple blocks through the tumour) are not explained in the same depth and with as many straightforward pictures as Steiner and Ambrosch’s text; but some of their diagrams have been included and do add to the quality of this book.

There is a danger that surgical interest in TLM will wane with the advent of robotic surgery, and we have started to witness this in the UK. However, the principles of transoral laser microsurgery are fundamental to any surgeon wishing to pursue robotics, and the breadth of pathology that can be treated by TLM far outweighs that of robotics currently. I would implore any trainee or consultant with an interest in transoral surgery for head and neck cancer to purchase this book and use it as a guide. The preoperative decision-making, postoperative rehabilitation and emphasis on outcomes data are real strengths of the textbook. The text does cover benign diseases, but not to the same extent as for the oncological resections. The airway work is described well but there may be better texts for surgeons with a specific interest in airway disease. The cricopharyngeal laser work could be expanded to discuss pros and cons versus open management, with reference to published failure rates and complications; but these are minor quibbles.

This is a multi-author text, but many of the chapters are written by the two lead authors. As such, there is very little overlap between chapters. The images are all of high quality and the practical tips described throughout are excellent. With the bulk of chapters being written by the lead authors, their treatment philosophy is very much set out. Most is uncontentious, but I have some concerns with the chapter on salvage laryngeal surgery. Whilst salvage TLM may work in experienced hands, such as theirs, systematic reviews have demonstrated a clear benefit in open partial laryngectomy over TLM in terms of local control.

In conclusion; an excellent textbook covering an important niche specialty in head and neck surgery. Highly recommended.

Share This
James O’Hara

The Freeman Hospital, Newcastle upon Tyne, UK.

View Full Profile